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Yudi Her Oktaviono
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Cardiovascular and Cardiometabolic Journal (CCJ)
Published by Universitas Airlangga
ISSN : 27466930     EISSN : 27223582     DOI : 10.20473/ccj.v1i2.2020.31-37
Core Subject : Health, Science,
Biochemistry, Genetics & Molecular Biology Immunology & microbiology Medicine & Pharmacology
- Adult cardiac surgery - Atherosclerosis - Cardiac imaging - Cardiac prevention - Cardiac rehabilitation - Cardiomyopathy - Cardiovascular immunology and infection - Congenital heart disease - Diabetes mellitus - Dyslipidaemia - Electrophysiological heart disease and arrhythmias - Extracorporeal circulation and cardiac perfusion - Heart failure - Hypertension and hypertensive heart disease - Ischaemic heart disease and coronary artery disease - Metabolic disorders and its linked to cardiovascular diseases - Pediatric cardiac surgery - Pericarditis and pericardial disease - Reactive oxygen species - Rheumatic valvular disease - Vascular disease
Arjuna Subject : Kedokteran - Cardiology and Cardiovascular Medicine
Articles 90 Documents
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Managing Acute Lung Edema During Hyperglycemic Crises: Prioritizing Fluid Reduction or Blood Sugar Control in Non-Specialist Settings Ardiansyah, Ryan; Putra, I Gusti Agung Gde Wilaja; Atmapraja, Lalu M Satrial Iip Widya
Cardiovascular and Cardiometabolic Journal (CCJ) Vol. 6 No. 1 (2025): Cardiovascular and Cardiometabolic Journal
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/ccj.v6i1.2025.39-45

Abstract

Background: Emergency admissions acute lung oedema and hyperglycemic crisis still very common and challenging. Both conditions are emergencies, where delay in treatment will cause increased morbidity and mortality. This report will discuss the case of a 62-year-old woman with acute lung oedema and hyperglycemia, as well as her emergency management. Case Summary: A 62-year-old woman present with severe shortness of breath since 2 hours before admission. The patient has a history of hypertension, diabetes mellitus, and heart disease and has not recently taken medication regularly. Physical examination revealed blood pressure: 260/132 mmHg, and SpO2: 86% Room Air. Thorax examination revealed vesicular sounds +/+, wheezing +/+, and full rhonki +/+ throughout the lung fields. Laboratory examination showed a blood sugar value of 539mg/dL. Chest X-ray shows cardiomegaly and pulmonary edema. Our patient was diagnosed with Acute Lung Oedema, hyperglycemia crisis, Hypertensive emergency. Conclusion: Management of patients with hyperglycemia and acute lung oedema is carried out simultaneously by the respective recommendations given. However, the rehydration volume in this case needs to be modified and it is important to provide fluid resuscitation conservatively. Hemodynamic assessments need to be carried out to ensure adequate fluid administration so as not to cause overhydration. -- Highlights: 1. This case underscores the challenge of managing hyperglycemic crisis alongside acute lung edema, emphasizing the importance of conservative, hemodynamically guided fluid resuscitation to balance rehydration needs with pulmonary safety.
Investigation on Prediction of Life-Threatening Arrhythmia in Long QT Syndrome : A Systematic Review and Meta-Analysis Lee, Jonathan Vincent; Emmanuela, Mirela; Lee, Jonathan Bryan
Cardiovascular and Cardiometabolic Journal (CCJ) Vol. 6 No. 1 (2025): Cardiovascular and Cardiometabolic Journal
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/ccj.v6i1.2025.26-38

Abstract

Introduction : Use of risk stratification tools in  Long QT Syndrome (LQTS) will be important to direct treatment strategy on each patient and risk of arrhythmia. There are still other factor that could improve the predictive performance of the risk stratification. This study aims to find a new predictor of Life-Threatening Arrhythmia in the LQTS population. Methods : Based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocol  (PRISMA) Protocol 2015,  studies  extracted  from  Pubmed, Science Direct, Pubmed Central, EuroPMC, Frontiers with MeSH keywords “Long QT Syndrome AND Predictor AND Life-threatening arrhythmia”. The inclusion criteria were cohort studies in LQTS patients (LQT 1, 2, 3) and the endpoint was life-threatening arrhythmia such as aborted cardiac arrest or sudden cardiac death. Study quality assessed with Newcastle-Ottawa Scale and RevMan 5.4 were used to analyse the data with hazard ratio as the measures. Results : Six  cohort studies  (12.343  subjects)  fulfilled  the  inclusion  criteria. Male <13 years old (HR = 2.73, 95% CI = 1.72-4.33, p = <0.0001) and female >13 years old (HR = 1.81, 95% CI = 1.36-2.41, p = <0.0001) were significant as predictor of life-threatening arrhythmia. Patients with LQT2 (HR = 1.84, 95% CI = 1.36-2.49, p = <0.0001), LQT3 genotype (HR = 3.88, 95% CI = 2.27-6.62, p = <0.00001), and QTc >530 (HR = 2.45, 95% CI = 1.96-3.06, p <0.00001) were also at increased risk of life-threatening arrhythmia.  Syncope occurrence increased the risk (HR = 3.11, 95% CI = 2.47-3.91, p = <0.00001) while beta-blockers usage significantly decreased the risk of life-threatening arrhythmia (HR = 0.46, 95% CI = 0.36-0.60, p = <0.00001). All studies were low risk of bias. Conclusion : There were other predictors of life-threatening arrhythmia in LQTS that might be considered to improve the stratification performance. -- Highlights: 1. In patients with Long QT Syndrome, life-threatening arrhythmia risk is strongly predicted by age-dependent gender differences, prolonged QTc (>530 ms), prior syncope, genotype (LQT2/3), and mitigated by beta-blocker use—offering a sharper edge for clinical risk stratification.
High Output Heart Failure Secondary Due to Large Arteriovenous Fistula Kwandou, Willis; Pribadi, Harry; Panda, Agnes Lucia
Cardiovascular and Cardiometabolic Journal (CCJ) Vol. 6 No. 1 (2025): Cardiovascular and Cardiometabolic Journal
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/ccj.v6i1.2025.46-52

Abstract

Background: Arteriovenous fistula (AVF) creation is a commonly performed procedure for patients who suffered from end-stage renal disease (ESRD) and require a permanent vascular access in order to receive long-term hemodialysis. However, these AVF may have a significant deleterious effect on cardiac hemodynamic functions due to increasing cardiac output (CO) and can lead into high output heart failure. Case Summary: Female, 36 years old complained dyspnea on effort, ascites and lower extremity oedema since 6 months ago. She had history of chronic kidney disease and routinely undergoing hemodialysis with brachiocephalic AVF that enlarged since 2 years ago. Physical examination revealed increased jugular vein pressure, hepatomegaly, ascites and giant draining vein of left brachiocephalic AVF with positive Nicoladoni-Branham sign. Echocardiography examination showed dilated right atrium and right ventricle, left ventricle diastolic D-shaped, normal left ventricular ejection fraction with increase right ventricle CO and cardiac index (CI) 7,8 L/minutes/m2, moderate pulmonary regurgitation, severe tricuspid regurgitation (TR) and high probability of pulmonary hypertension. Vascular ultrasound revealed enlarged draining vein with high AVF blood flow rate. Patient then referred to vascular surgeon and decided to undergo ligation of AVF draining vein. After ligation, patient’s right heart failure symptoms were improved and had a better quality of life. upon echocardiography control examination revealed significant improvement of left ventricle diastolic D-shaped. Conclusion: High output heart failure is one of a potential serious complication upon creating AVF hemodialysis vascular access. Routine screening of AVF blood flow rate, identifying high risk patients, and early management is very important to prevent irreversible myocardial damage. -- Highlights: 1. This case illustrates that high-output heart failure from an excessively flowing AVF—though rare in younger patients—can be dramatically reversed with AVF ligation, highlighting the importance of flow assessment and timely intervention in dialysis patients with unexplained right heart failure.
Balancing Risk and Benefit of Antiplatelet Therapy in the Acute Coronary Syndrome Patient with Thrombocytopenia: A Case Report Putra, Ngurah Agung Reza Satria Nugraha; Hendrijanto, Johanes David; Susila, I Ketut
Cardiovascular and Cardiometabolic Journal (CCJ) Vol. 6 No. 1 (2025): Cardiovascular and Cardiometabolic Journal
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/ccj.v6i1.2025.53-59

Abstract

Background: Antiplatelets are one of the cornerstones of treatment for Acute coronary syndrome (ACS), although it is risky in patients with thrombocytopenia. In choosing antiplatelets, physicians must carefully weigh the risks of ischemia and bleeding. Case Summary: A 68-year-old male came to ED with a 2-day history of left-sided chest pain, exacerbated 1 hour before admission. The preliminary ECG revealed ST elevation in lead V2-V5 and laboratory examination showed low platelets in four days (32x103/uL; 29x103/uL; 47x103/uL; 87x103/uL). The patient received a loading dose of Aspirin 160 mg. However, Clopidogrel 1x75mg was administered on the second day of treatment. After 5 days of treatment, the patient's condition improved, and his platelet count increased steadily. Conclusion: Antiplatelet therapy is required to avoid ischemic complications, but it enhances the risk of bleeding in individuals with thrombocytopenia. There have been few studies on the use of antiplatelets in thrombocytopenia. Monotherapy is preferred over dual therapy, however the risk/benefit ratio, clinical response, and monitoring for bleeding issues in the patient must all be considered. -- Highlights: 1. This case illustrates that cautious antiplatelet monotherapy may be a viable strategy in ACS patients with thrombocytopenia. In this 68-year-old with ST-elevation MI and platelets <50×10³/μL, delayed Clopidogrel monotherapy—guided by clinical stability and rising platelet counts—led to improvement without bleeding complications.
Profile of Maternal Mortality due to Cardiovascular Disease Based on Determinant Factors at Dr. Soetomo Regional General Hospital Akhmad Adam Mahendra; Andrianto; Muhammad Ardian Cahya Laksana
Cardiovascular and Cardiometabolic Journal (CCJ) Vol. 6 No. 1 (2025): Cardiovascular and Cardiometabolic Journal
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/ccj.v6i1.2025.1-8

Abstract

Background: Although Indonesia’s maternal mortality rate (MMR) decreased from 346 per 100,000 live births in 2010 to 189 in 2020, it remains high compared to other Southeast Asian countries. Cardiovascular diseases are among the leading indirect causes of maternal deaths globally, accounting for over 33% of cases. Objectives: This study aims to analyze maternal mortality due to cardiovascular disease at Dr. Soetomo Regional General Hospital based on determinant factors. Methods: This study was a descriptive analytical study utilized secondary data from medical records of 123 patients who experienced maternal deaths due to cardiovascular disease at Dr. Soetomo Hospital between January 2020 and December 2023. Determinants were categorized as near (cardiovascular diagnosis), intermediate (maternal age, gestational age, obstetric status, and delivery mode), and distant (occupation) factors. Results: Of 123 cases, the leading cardiovascular complications were hypertension in pregnancy (58.5%), congenital heart disease and pulmonary hypertension (15.4%), and cardiomyopathy and  heart failure (14.6%). Intermediate determinants included maternal age >35 years (28.5%), multigravida status (60.2%), multiparity (56.9%), and third-trimester presentation (65%). Most deaths (96.7%) occurred postpartum, with cesarean section being the predominant delivery mode (74.8%). The majority of patients were housewives (53.7%). Conclusion: Hypertension in pregnancy remains a primary near determinant of maternal mortality. Intermediate and distant determinants, such as maternal age, obstetric status, and socioeconomic factors, also contribute significantly. Efforts to reduce maternal mortality should include improved antenatal care, early cardiovascular screening, and targeted public health interventions. - Highlights: 1. This study reinforces hypertension in pregnancy (58.5%) as the leading cause of maternal mortality due to cardiovascular disease, highlighting its significant contribution compared to other conditions like congenital heart disease (15.4%) and cardiomyopathy (14.6%). 2. A striking 96.7% of maternal deaths occurred postpartum, with cesarean section (74.8%) being the predominant delivery mode, suggesting a need for enhanced postpartum monitoring and cardiovascular care in high-risk pregnancies.
Cardiac Tamponade in Post-CABG Surgery Patient: A Case Report of Post-Pericardiotomy Syndrome Lee, Jonathan Vincent; Emmanuela, Mirela; Lee, Jonathan Bryan; Damay, Vito Anggarino
Cardiovascular and Cardiometabolic Journal (CCJ) Vol. 6 No. 2 (2025): Cardiovascular and Cardiometabolic Journal
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/ccj.v6i2.2025.118-124

Abstract

Background: Cardiac tamponade is the situation where fluid accumulates in the pericardial cavity and compresses the heart, which leads to reduced cardiac output and shock. Their prevalence in post-open heart surgery, especially Coronary Artery Bypass Graft (CABG) surgery is 24% and commonly related to Post-Pericardiotomy Syndrome (PPS). Case Summary: A 57-year-old female with a history of CABG surgery presented to emergency with chief complaints of shortness of breath in the last 3 days, especially when lying down. The patient underwent CABG surgery from CAD2VD + LM in the last month. Physical examination found a muffled first & second heart sound and distended jugular vein. The electrocardiograph of the patient showed sinus rhythm with low voltage. Echocardiography was done on the patient, and the result showed severe pericardial effusion with a D shape and collapse of the right ventricle. We performed a pericardiocentesis with an initial drainage of 737 cc of serosanguineous fluid. Post-procedural echocardiography showed reduced pericardial effusion, good LV contractility, and RV not collapsed. Pericardial fluid analysis concluded it was a transudative type. Patient were stable on admission and discharged uncomplicated. This patient developed cardiac tamponade with a history of CABG surgery. Conclusion: Cardiac tamponade occurs frequently in post-CABG surgery patients, both in early and late onset. It is important to recognize the early signs of cardiac tamponade, as the condition does not always present during the early phase. This case also highlighted the importance of recognizing and preventing PPS as a delayed cause of tamponade, even when there is no apparent sign of systemic inflammation. -- Highlight: 1. A 57-year-old post-CABG patient presented with cardiac tamponade one month after surgery, ultimately diagnosed as post-pericardiotomy syndrome (PPS) based on clinical and imaging findings. 2. Prompt echocardiography-guided pericardiocentesis and recognition of PPS as a delayed inflammatory cause of tamponade highlight the importance of vigilance for late-onset complications after cardiac surgery.
Low Testosteron Level in Worsening Symptom of Heart Failure Patients: A Literature Review Ardiansyah, Ryan; Sauqy, Akhmad Sandy
Cardiovascular and Cardiometabolic Journal (CCJ) Vol. 6 No. 2 (2025): Cardiovascular and Cardiometabolic Journal
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/ccj.v6i2.2025.97-107

Abstract

Abstract Background: Heart failure can be caused by a variety of factors, including high blood pressure, coronary artery disease, diabetes, obesity, smoking, and genetics. Testosterone is the primary male hormone responsible for regulating sex differentiation, producing male sex characteristics, spermatogenesis, and fertility. It plays a crucial role in various bodily functions, including the development of male reproductive tissues and the maintenance of muscle mass and bone density. Testosterone levels have been found to be significantly decreased in heart failure patients compared to healthy controls. This suggests that low testosterone levels may play a role in the development or progression of heart failure. The relationship between testosterone and heart failure is complex and warrants further investigation. Additional research is needed to better understand the role of testosterone in heart failure and to determine the optimal therapeutic strategy for its management. Based on these data, we decided to further investigate how low testosterone levels affect the symptoms of heart failure patients. Aims: This literature review study aims to examine further how low testosterone levels affect the symptoms of heart failure patients. Method: Journals in this literature review used three databases, including Google Scholar, PubMed, and Science Direct, using the keywords "testosterone" and "heart failure." The literature search was adjusted based on the inclusion and exclusion criteria. Result: The search results were obtained from 10 international journals. The results showed that testosterone is crucial in maintaining men's health and well-being. Testosterone deficiency was associated with a worsening of HFpEF in men, those with lower testosterone levels had worse symptoms and a lower quality of life. Conclusion: Testosterone exerts an important regulation of cardiovascular function through genomic and nongenomic pathways. It influences contractility, energy metabolism of myocardial cells, apoptosis, and the remodeling process. Reduced testosterone levels in men with heart failure are associated with increased mortality and poor prognosis. -- Highlights: 1. Testosterone deficiency is associated with worsening symptoms and poorer quality of life in men with heart failure with preserved ejection fraction (HFpEF). 2. The role of testosterone in cardiovascular health is multifaceted—its deficiency may contribute to adverse cardiac remodeling, while excessive levels may increase thromboembolic and inflammatory risks.
Consequences of Hypervitaminosis D in NZW Rabbit Model: Vitamin D Toxicity Ahmed, Mohamed; Prasad, Kailash; Shoker, Ahmed
Cardiovascular and Cardiometabolic Journal (CCJ) Vol. 6 No. 2 (2025): Cardiovascular and Cardiometabolic Journal
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/ccj.v6i2.2025.83-96

Abstract

Background and Aim: This study examines the effect of hypervitaminosis D on serum lipids and on kidney functions in New Zealand White (NZW) rabbit. It aims to study whether renal insufficiency or failure, due to hypervitaminosis D, is calcium-related or not. As well, it also discusses a possible link between hypervitaminosis D and hypercholesterolemia. Methods: Four Groups of six animals each, were divided into: Group I, received regular diet, Group II received regular diet +10,000/day vitamin D2; Group III, received 0.25% cholesterol diet; as well as Groups IV received 0.25% cholesterol diet plus 10,000 IU. Blood samples were taken at the end of the study and examined for Total Cholesterol (TC), Triglycerides (TG), Low Density Lipoprotein (LDL), High Density Lipoprotein (HDL), Blood Urea Nitrogen (BUN), Creatinine, Alanine Aminotransferase (ALT), Aspartate Aminotransferase (AST), Alkaline Phosphatase (ALP), Calcium and Phosphate. As well, 25- hydroxyvitamin D (25 (OH) D) was measured using tandem LC-MS/MS. Results: The initial (0 time) serum TC, TG, LDL, HDL, Creatinine, Calcium, Phosphate and 25 (OH) D levels were not significantly different among different groups including control. At 1- and 2-month time, values from serum TC, TG, LDL, HDL and TC/HDL-C ration of Groups III and IV were significantly different from controls (p<0.05). As well, values from serum 25 (OH) D of Group II and IV were significantly different from controls (p<0.05) at 1- and 2-month time. However, values from serum Creatinine and Calcium of Group II were significantly different from controls (p<0.05) at 1- and 2-month time. Conclusion: Hypervitaminosis D may aggravate hypercholesterolemia, and it also induces renal insufficiency and/ or failure through a calcium-dependent mechanism. -- Highlights: 1. Excessive vitamin D supplementation, particularly when combined with a hypercholesterolemic diet, aggravated hyperlipidemia and elevated serum calcium levels in NZW rabbits. 2. Hypervitaminosis D was associated with increased serum creatinine and hypercalcemia, suggesting potential renal impairment secondary to excessive vitamin D intake
Predictors of Radial Artery Occlusion in Patients with Coronary Heart Disease Undergoing Coronary Angiography or Percutaneous Coronary Intervention via Transradial Access Sumadio, Muhammad Yolandi; Sitepu, Inri Pepayosa; Nina Apriyani Harefa; Nova Syafriana; Syarifuddin, Fairuz
Cardiovascular and Cardiometabolic Journal (CCJ) Vol. 6 No. 2 (2025): Cardiovascular and Cardiometabolic Journal
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/ccj.v6i2.2025.67-72

Abstract

Background: Transradial approach is currently the most recommended access for coronary angiography and percutaneous coronary intervention (PCI). However, the risk of developing radial artery occlusion (RAO) with this approach is not uncommon. Objective: This study aims to determine the frequency and predictors of RAO in patients undergoing transradial access. Method: This was a prospective study from January 2021 until December 2023. Participants underwent coronary angiography or PCI via transradial access. Radial artery patency was evaluated before and after the procedure. Results: A total of 456 subjects were enrolled for the study. RAO was found in 37 of 456 subjects (8.1%). From the results of the multivariate analysis, it was found that age (p = 0.012), number of catheters used (p = 0.006), and the incidence of hematoma (p < 0.001) were independent predictors of the incidence of RAO. Conclusion: RAO is a common complication of transradial access so identification of high-risk patients, prevention efforts and close follow-up must be carried out to maintain a patent radial artery. Keywords: percutaneous coronary intervention; radial artery occlusion; transradial -- Highlights: 1. Older age, multiple catheter use, and post-procedural hematoma were identified as independent predictors of radial artery occlusion in patients undergoing transradial coronary angiography or PCI. 2. Early recognition of high-risk patients and careful procedural management are essential to prevent radial artery occlusion and preserve long-term radial artery patency
A Rare Case of Acute Purulent Myopericarditis Due To Klebsiella Pneumoniae: Challenge in Diagnosis and Management Pertiwi, Gusti Ayu Riska; Amijaya, Agus Gowinda; Maliawan, Rani Paramitha Iswari
Cardiovascular and Cardiometabolic Journal (CCJ) Vol. 6 No. 2 (2025): Cardiovascular and Cardiometabolic Journal
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/ccj.v6i2.2025.108-117

Abstract

Background: Acute purulent myopericarditis due to Klebsiella pneumoniae is an uncommon condition in the current era of widespread antibiotic use. The condition can lead to rapid fluid buildup around the heart, causing cardiac tamponade and sepsis, both of which can be life-threatening. The typical manifestation of myopericarditis may be absent and possess significant challenges in diagnosis and treatment. Imaging techniques can detect pericardial effusion or inflammation, but it cannot identify the exact cause. Early diagnosis and treatment are essential to improve patient outcomes. This article was conducted to report a case of acute purulent myopericarditis caused by Klebsiella pneumoniae that is barely reported. Case Summary: A male, 52 years old, presented with prolonged fever, progressive dyspnea and palpitation. The physical and supporting examination only showed the clinical symptoms of thyroid storms, heart failure, and coronary artery disease. Acute purulent myopericarditis was developed three days after therapy, proven by echocardiography, laboratory, and myopericardial fluid analysis. Purulent mixed hemorrhagic fluid was evacuated from pericardiocentesis with positive culture for Klebsiella pneumoniae sensitive to ceftriaxone. Ceftriaxone, ibuprofen, and colchicine were given. Constrictive pericarditis was found, so surgical pericardiectomy was performed. The patient showed significant clinical and echocardiographic improvement, discharged in stable condition. Conclusion: Myopericarditis should always be kept in mind as differential diagnosis in patient with pericardial effusion and when it rapidly deteriorated, purulent bacterial infection although rare could be the possible cause. Prompt intervention through fluid evacuation, adequate antibiotic therapy and surgical pericardiectomy when indicated, were needed to improve disease outcome -- Highlight: 1. A rare case of purulent myopericarditis caused by Klebsiella pneumoniae presented with atypical features, leading to diagnostic challenges in a patient with multiple comorbidities. 2. Early recognition, multimodal imaging, and prompt intervention—including pericardiocentesis, antibiotics, and surgical pericardiectomy—proved lifesaving and highlight the importance of individualized management in such rare infections.

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